03D2239158 CLIA NUMBER - EXECUTIVE HEALTH DEPARTMENT AT DISCOUNT TIRE

Laboratory Demographics

  • CLIA Code: 03D2239158
  • Facility Name: EXECUTIVE HEALTH DEPARTMENT AT DISCOUNT TIRE
  • Facility Address: 20225 N SCOTTSDALE RD
    SCOTTSDALE, AZ
    ZIP 85255
  • Facility Phone: 480 249-2350
  • Facility Type: Health Main. Organization
  • Facility Type: Waiver
  • Lab Director: CAMERON R. SHARP
  • NPI Number: 1548582091
  • Taxonomy: 235Z00000X - Speech-Language Pathologist

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CLIA Record

Field Name Field Value
CLIA Number 03D2239158
LAB Type Health Main. Organization
Facility Name EXECUTIVE HEALTH DEPARTMENT AT DISCOUNT TIRE
Street 20225 N SCOTTSDALE RD
City SCOTTSDALE
State AZ
ZIP 85255
Phone 480 249-2350
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/8/2023
Certificate Expiration Date 10/7/2025
Facility Type Health Main. Organization
Lab Director CAMERON R. SHARP

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This page was last updated on: 9/29/2025